PyCharm Professional lets you use a remote docker-compose interpreter[1] which brings back that live debugging experience. I did have to work pretty hard to figure out the correct strings to launch Gunicorn and connect to nginx. But it's all worth it to be able to evaluate code at a breakpoint and refresh my code changes without relaunching all my containers.

[1]: https://www.jetbrains.com/help/pycharm/using-docker-compose-...